18 February 2020

UTS CRICOS PROVIDER CODE 00099F

Cancer Symptom Trials (CST) Annual Research Forum 2020 Program

Cancer Symptom Trials receives funding from Cancer Australia

Vision 2030: Cancer Symptom Trials

Aerial Function Centre Ultimo NSW 18 February2020

18 February 2020

Contents Venue 1

Aerial UTS Function Centre 1

Car parking 1

Refreshments 1

Wi-Fi 1

Electronic devices 1

Social Media 1

Message from the Chair 2

Membership 3

Program 4

CST Chair 5

New study presentation 5

Session Chairs 6

Speakers 7

Medication repurposing panel 8

Consumer panel 9

Posters 10

1

Venue

Aerial UTS Function Centre

• Location: Level 7, UTS Building 10. Enter at 235 Jones St Ultimo Foyer - take the lift to level 7

• Aerial is a 5-minute walk from Central Railway Station; it is a 30-minute drive from the airport

• Further information:

o T: 02 95614 1632

o F: 02 9514 1404

o E: aerialfunctions@uts.edu.au

Car parking Interpark University of Technology Sydney Car Park Thomas Street, Ultimo Wilson Parking Hotel Novotel Sydney Central Car Park 169-179 Thomas Street, Haymarket Broadway Shopping Centre Parking 1 Bay Street, Broadway Wilson parking Market City Car Park 2 Quay Street, Haymarket

Refreshments Coffee and tea on arrival, morning tea, lunch and afternoon tea will be provided to all delegates.

Wi-Fi Complimentary Wi-Fi will be available to all delegates, login information will be provided.

Electronic devices We recognise that some phone calls cannot wait but we do ask that electronic devices are in silent mode and all phone calls are promptly taken outside the presentation room during session.

Social Media We encourage tweeting about the event using hashtag #CST2020, however please refrain from tweeting the new ideas of other members.

2

Message from the Chair

Welcome to the Cancer Symptom Trials (CST) Annual Research Forum 2020 and thank you for

your interest in CST. CST acknowledges the Gadigal People of the Eora Nation upon whose

ancestral lands we are holding our forum, extending our respect to Elders both past and

present, acknowledging them as the traditional custodians of knowledge for this land.

We are delighted to welcome our Keynote Speaker, Professor Vickie Baracos, from the

University of Alberta. We have an exciting program covering a breadth of symptom trials

research with a particular focus on cachexia, cancer consumers perspectives of the key issues

for symptom trials, and innovative methods which will equip us to conduct world-class trials in

this field.

With the number of people in Australia with a cancer diagnosis projected to grow, equally the

number of people impacted by the burden of symptoms due to cancer and its treatment with

significant impacts on quality of life will also grow. CST was established in 2017 to directly

address the growing symptom management needs of Australians living with cancer through

investigator initiated or academic (industry-independent) clinical trials.

CST has gone from strength to strength, within a short period of time building a comprehensive

portfolio of clinical trials that will accelerate the improvement of cancer symptom management

and quality of life for all people living with cancer. We are broadening the consumer, clinician

and researcher base engaged in developing and conducting these trials, strengthening

pipelines from pre-clinical research; and attracting competitive NHMRC category 1 clinical trials

funding.

CST is a multidisciplinary research collaborative with expertise in clinical trial design, symptom

interventions and supportive care, with a consumer advisory panel who is integral to inform our

approach and priorities. Our membership includes health professionals, researchers and

experts from a range of disciplines. Members are the driving force behind new study ideas for

the collaborative and contribute to proactive concept development and identification of critical

challenges to be addressed by clinical trials in the future.

Our two critical research focus areas are:

• Find better ways to manage symptoms that occur as a result of a cancer diagnosis or its

treatments.

• Improve the quality of life for people with cancer and their carers through prevention, early

identification, assessment and treatment of symptoms.

CST acknowledges the important core infrastructure funding from the Australian Federal

government through Cancer Australia and the funding from competitive grants that support the

conduct of our research. We also welcome donations from the community and invite you to

support our research through the UTS Giving program.

I hope you enjoy the CST forum, and leave motivated to become a member and get involved in

this critical area of research. You can get in touch with us by e-mail to CST@uts.edu.au.

Professor Meera Agar

Chair, Cancer Symptom Trials

3

Membership

Current members

Cancer Symptom Trials (CST) appreciates your support in building a diverse membership

community who share skills and knowledge that contribute to new ideas in cancer symptom

management. We encourage you to promote CST membership to colleagues, associates,

consumer advocates and other potential new members.

New applicants

CST welcomes membership applications from health professionals and researchers who have

an interest in cancer symptoms and supportive care clinical trials. CST membership is free and

open to health professionals and researchers from Australia and New Zealand who are

interested in cancer symptom management. Membership does not need to be renewed

annually. Associate membership is available to international researchers, consumers and

industry representatives.

Member benefits include:

• access to professional and research networks in the field of cancer symptom

management

• access to concept development workshops and other CST support to develop trial

concepts

• regular newsletters and information about CST activities including opportunities to be

involved in CST clinical trials and clinical trial development

• invitations to attend the CST annual scientific meeting and other workshops organised

by CST

• access to discounted membership of the Clinical Oncology Society of Australia (COSA)

To find out more and apply for membership, go to www.uts.edu.au/cst/membership.

4

Program

9.00 – 9.30 Registration Aerial UTS Function Centre

Building 10 | Level 7 | 235 Jones Street Ultimo

9.30 – 9.35 Welcome and Acknowledgment of

Country

Professor Suzanne Chambers

Dean Faculty of Health, University of Technology Sydney

Sessio

n C

ha

ir:

Pro

fesso

r

Su

zan

ne

Ch

am

be

rs

9.35 – 9.50 Opening address Professor Dorothy Keefe

CEO Cancer Australia

9.50 – 10.50 Keynote speaker: Clinical trials of

Cancer Cachexia Therapy

Professor Vickie Baracos

Alberta Cancer Foundation Chair in Palliative Care

Medicine, Department of Oncology, University of Alberta

10.50 - 11.20 Morning tea and poster viewing

11.20 – 11.50 Guest speaker: Valuing the symptoms

patients experience in cancer care

Associate Professor Richard De Abreu Lourenco

Health Economist, Centre for Health Economics

Research and Evaluation (CHERE)

Sessio

n C

ha

ir:

Pro

fesso

r Jan

e P

hillip

s

11.50 – 12.50 Consumer panel: Why cancer symptom

Trials matter

Dr Phillip Lee

IMPACCT/CST Consumer Representative

Desma Spyridopoulos

COGNO Consumer Representative

Laurence Hibbert

ANZCHOG Consumer Representative

Jason White

PoCoG Consumer Representative

Andrea Cross

IMPACCT/CST Consumer Representative

12.50 – 1.30 Lunch and poster viewing

1.30 – 2.00

Symptom Note Subcommittee

Presentations: overview of current

program of work for each node

Dr Tina Naumovski

Appetite and Cachexia

Professor Melanie Lovell

Pain

Dr Kat Urban/Dr Gemma Ingham

Fatigue

Associate Professor Phillip Good

Nausea

Sessio

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ha

ir:

Asso

cia

te P

rofe

sso

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rian

Le

2.00 – 3.00 Panel: Medication repurposing

Professor David Currow

PaCCSC Chief Investigator

Emeritus Professor Richard Head

CST Chair, Scientific Advisory Committee

Emeritus Professor Lloyd Sansom AO

School of Pharmacy and Medical Science, University of

South Australia

Associate Professor Nikola Bowden

Research Fellow, School of Medicine and Public Health,

The University of Newcastle

3.00 – 3.15 Afternoon tea and poster viewing

3.15 – 4.00

New study presentation: Ahem. You

want to treat my cough with what?

Paroxetine for the treatment of refractory

chronic cough in cancer: a pilot,

randomised, placebo-controlled phase III

study

Dr Sonia Fullerton

Consultant in Palliative Medicine, Peter MacCallum

Cancer Centre

4.00 – 4.15 Closing Professor Meera Agar

CST Chair

5

CST Chair

Professor Meera Agar

Professor Meera

Agar is a palliative

medicine physician

with a particular

interest in delirium,

supportive care

needs of people with

brain tumours and geriatric oncology.

Meera leads a clinical research portfolio at

UTS, including clinical trials and health

service evaluation in cancer and palliative

care. She led a world-first clinical trial of

antipsychotics in delirium and is leading

New South Wales Government-funded

clinical trials of medicinal cannabis for

anorexia in people with advanced cancer. A

Fellow of the Royal Australasian College of

Physicians, Fellow of the Australasian

Chapter of Palliative Medicine, and clinician

scientist, she holds a Master in Palliative

Care a doctorate in the area of delirium in

advanced illness. Her research and

teaching have won numerous awards,

including an Australian Learning and

Teaching Council (ALTC) Citation, an

Australian Award for University Teaching

and the European Association for Palliative

Care (EAPC) Early Career Researcher

Award.

CST Annual Research Forum 2019

New study presentation Dr Sonia Fullerton

Dr Sonia Fullerton is a palliative care physician working at the Victorian Comprehensive Cancer Centre in Melbourne. Her interests include complex symptom management, advance care planning and social media in health. A holder of a Master’s in Health Service Management, she sits on the Committee of Management at Banksia Community Palliative Care.

6

Session Chairs

Professor Suzanne Chambers

Professor Suzanne

Chambers is Dean of

the Faculty of Health

at the University of

Technology Sydney.

Prior to joining UTS,

she was the Director

of the Menzies Health Institute of

Queensland at Griffith University. She is a

health psychologist and registered nurse

who has worked as a practitioner and

researcher in psychological support for

people with cancer for over 30 years.

Professor Chambers is an Officer of the

Order of Australia for distinguished service

to medical research, particularly in the area

of psycho-oncology, and to community

health through patient care strategies to

assist men with prostate cancer. She has

published extensively on the psychosocial

effects of cancer with over 260 peer-

reviewed publications and books and has

been a chief investigator on successful

research grants valued at over $30 million

from the NHMRC, ARC, Prostate Cancer

Foundation of Australia, Cancer Australia,

Beyond Blue and Cancer Council

Queensland. She leads an NHMRC Centre

for Research Excellence in Prostate Cancer

Survivorship. Professor Chambers holds

adjunct professorships at Griffith University,

Edith Cowan University and the University

of Southern Queensland.

Professor Jane Phillips

Professor Jane

Phillips is the Director

of IMPACCT. She

has extensive

experience in cancer

and chronic disease

nursing and

research. She has delivered evidence-

based palliative care across diverse

settings including regional and rural

Australia. Professor Phillips has led and

evaluated complex health service reforms

and has led a number of major cancer and

palliative care reform initiatives at local and

national levels. Her research aims to

strengthen the links between research,

policy and practice.

Associate Professor Brian Le

Brian is the Director

of Palliative Care at

the Victorian

Comprehensive

Cancer Centre

including the Peter

MacCallum Cancer

Centre and The Royal Melbourne Hospital.

He is a specialist in both palliative medicine

and medical oncology and is an Associate

Professor at the University of Melbourne.

Brian is past Chair of the Training

Committee of the Royal Australian College

of Physicians, responsible for training of all

palliative medicine specialists in Australia

and New Zealand. Brian has roles with

Commonwealth, state government and not-

for-profit organisations in palliative care and

is a past Chair of Palliative Care Victoria.

Brian has published over 75 peer reviewed

scientific papers and book chapters. He is

involved with research in the areas of

palliative and supportive care, including

clinical trials of novel therapies as well as

research into palliative care integration and

benefits for patients and carers.

7

Speakers

Professor Dorothy Keefe, MBBS, MSc, MD, FRACP, FRCP(Lon)

Professor Dorothy

Keefe is the CEO of

Cancer Australia,

having taken up the

position in July 2019.

Prior to this she had

a long career as a

medical oncologist at the Royal Adelaide

Hospital, and as Professor of Cancer

Medicine at the University of Adelaide,

where she remains an Honorary Clinical

Professor. She has an ongoing long-term

research interest in Supportive Care in

Cancer, particularly in gastrointestinal

toxicity of cancer treatment. She ran a

laboratory studying mechanisms and

interventions for over 20 years. She is a

past-President of the Multinational

Association of Supportive Care in Cancer

(MASCC). Professor Keefe has led cancer

services at hospital, local health network

and state levels, and spent 4 years as

clinical lead of health reform in South

Australia. She has a Master’s in Medical

Leadership and has a strong interest in

advocacy and in career development and

mentoring. In 2013 she was awarded a

Public Service Medal for her service to

public health, medical research and

oncology.

Professor Vicky Baracos, BSc, PhD, PDF

Professor Vickie

Baracos is Alberta

Cancer Foundation

Chair in Palliative

Care Medicine in the

Department of

Oncology, University

of Alberta. Her long-term focus has been

the pathophysiology of skeletal muscle

atrophy in an effort that encompasses

fundamental and translational research, a

clinical agenda and an international network

of strategic collaboration. Cancer cachexia,

a debilitating condition characterised by

profound atrophy of skeletal muscle is her

main focus since 2003. Some key

publications include Baracos VE et al.

Cancer-associated cachexia. Nat Rev Dis

Primers. 2018; 4:17105; Martin L et al.

Diagnostic criteria for the classification

of cancer-associated weight loss. J Clin

Oncol. 2015;33(1):90-9. Fearon K et al.

Definition and classification of cancer

cachexia: an international consensus.

Lancet Oncol. 2011;12(5):489-95.

Professor Baracos developed the use of

clinical computed tomography to detect and

precisely measure the muscle loss, which is

an integral part of cachexia. Muscle loss is

strongly associated with severe

chemotherapy toxicity, complications of

surgery and mortality in patients with

different cancers.

Associate Professor Richard De Abreu Lourenço, PhD

Richard is an

Associate Professor

with CHERE. He is

an experienced

health economist

who has a keen

interest in applied

economic evaluations, patient preference

and quality of life and the economics of

specialty health areas. Currently, he is the

Program Lead for the Cancer Australia

Cancer Research Economics Support

Team, and the Senior Evaluator for

CHERE’s Pharmaceutical Benefits Advisory

Committee (PBAC) evaluation group. He is

an investigator on a number of cancer

clinical studies and studies investigating

preferences for health care decision making

.

8

Medication repurposing panel

Professor David Currow

Professor David

Currow is an

internationally

recognised expert in

improving the delivery

of palliative care. He is

a Professor in the

Faculty of Health, UTS and the Chief

Investigator of the Palliative Care Clinical

Studies Collaborative (PaCCSC). He is an

active researcher with contributions in clinical

trials, population-based planning and

codifying the evidence base underpinning

palliative care. David has published more

than 500 peer-reviewed articles, editorials

and books. He is Senior Associate Editor of

the Journal of Palliative Medicine and is on

the Advisory Board for the Journal of Pain

and Symptom Management and BMJ

Supportive and Palliative Care. He is an

editor of the 5th and 6th editions of the Oxford

Textbook of Palliative Medicine.

Emeritus Professor Richard Head

Professor Richard

Head is a

pharmacologist and

Emeritus Professor in

the Division of Health

Sciences, University of

South Australia,

Affiliate Professor in the Discipline of

Pharmacology, The University of Adelaide,

and Honorary CSIRO Fellow. He is a former

Deputy Vice Chancellor & Vice President:

Research and Innovation for the University of

South Australia. Richard has served as

Director of CSIRO’s P-Health National

Flagship and Chief of CSIRO’s division of

Health Sciences and Nutrition as well as

Chief of CSIRO’s Division of Human

Nutrition. He was Professor of Pharmacology

and Toxicology at West Virginia University

Medical Centre, a Research Fellow with the

Department of Medicine at the University of

Melbourne and Postdoctoral Research

Fellow at the Roche Institute of Molecular

Biology USA.

Emeritus Professor Lloyd Sansom AO

Emeritus Professor

Lloyd Sansom AO

has played a major

role in the

development of

Australia’s National

Medicines Policy. He

has sat on numerous government and

industry advisory groups. Lloyd has played a

major role in the development of Australia’s

National Medicines Policy and is a past chair

of the Australian Pharmacy Advisory Council.

Lloyd is a member of the Medication

Reference Group of the Australian Safety

and Quality Commission. He is Chair of the

Advisory Board of the Palliative Care

Research Collaboration and of the Centre of

Health Economics Research and Evaluation

at UTS as well as a director of Bellberry Ltd,

a not-for-profit human research ethics

company. Lloyds serves on a number of

Committee and is a life member of the

Australian Pharmaceutical Sciences

Association and of the Australasian Society

of Clinical and Experimental Pharmacologists

and Toxicologists.

Associate Professor Nikola Bowden

Associate Professor

Nikola Bowden is a

Co-Director of the

University of

Newcastle Centre for

Human Drug Research

and leads the DNA

Repair Group. Her research has the overall

aim of delivering personalised diagnosis and

treatment to patients with cancer, with a more

focused interest in investigating DNA repair

and drug repurposing for melanoma and

ovarian cancer.

9

Consumer panel

Dr Philip Lee, IMPACCT Consumer Representative Dr Philip Lee is the former Director of

Supportive and

Palliative Medicine at

Western Sydney

Local Health District

and Senior Staff

Specialist, Palliative

Medicine at the

Crown Princess Mary

Cancer Centre, Westmead Hospital.

Following his retirement in July 2017, Philip

became a consumer representative and

continues to advocate for patients and

families.

Desma Spyridopoulos, COGNO Consumer Representative

Desma is an

experienced

entrepreneur and

Director of an IT

consultancy in

Sydney. Her interest

in COGNO began

when her father was

diagnosed with a Stage 4 Glioblastoma in

2016. She believes that the CAP plays an

important role safeguarding the patient’s

needs in brain cancer trials.

Jason White, PoCoG Consumer Representative

Jason is a member

of the Consumer

Advisory Group at

the Psycho-oncology

Co-operative

Research Group

(PoCoG). Jason is a

carer for his wife with

breast cancer, lupus and Hashimoto’s. He

also supported his mother during bowel

cancer and terminal secondary ovarian

cancer. Professionally, Jason is a Data

Analyst at The University of Sydney.

Laurence Hibbert, ANZCHOG Consumer Representative

Following his son's

treatment for acute

myeloid leukaemia

as an infant in 2008,

Laurence has

become increasingly

involved in paediatric

oncology and general paediatric health

advocacy. He has developed ward-based

activities for patients and their families

including breakfasts and celebration bell

ringing evenings. Laurence also sits on the

consumer committees of the Sydney

Children's Hospital Network and

ANZCHOG. In his day job he is a solicitor

working primarily in wills and estates where

he regularly prepares documents for

patients with cancer.

Andrea Cross, CST Consumer Representative

Andrea Cross is a

cancer survivor who

has undergone major

surgery and

completed a course

of adjuvant

chemotherapy. She

is a retired

audiologist, who over 30 years ago moved

from New Zealand to regional NSW with

her husband to establish a General Practice

and Audiology Service. Andrea is an active

community member and a past President of

her local Business and Professional

Women’s Association and has been a keen

supporter of the Coffs Coast Dragon Boat

Association. As a cancer consumer she

brings her perspective and experiences of

being diagnosed and treated for cancer at a

Regional Integrated Cancer Centre. She is

passionate about working with clinicians

and scientists to answer the many

unanswered symptom management

questions and to ensure that rural

Australians have better access to best

evidence-based cancer care.

10

Posters

Duloxetine and Pregabalin for Neuropathic Cancer Pain (DEPARTURE)

K Clark, H Matsuoka, J Lee, J Philips, M Agar, D Currow, M Lovell, S Kochovska, B Le, B Noble, L Brown, B Fazekas

Neuropathic cancer pain is experienced by

almost a third of cancer pain sufferers and it

does not respond well to opioid drugs.

Gabapentinoids, such as pregabalin have

become the standard of care to treat this

type of pain, however other analgesics that

work through different pathways might be

just as effective. This study will compare

duloxetine, a selective serotonin

noradrenalin reuptake inhibitor, with

pregabalin to see whether it can offer a net

benefit (pain management and less side

effects).

Older people with Cancer

M Agar (Lead Investigator)

In Australia, the proportion of older people

over 65 years is increasing, corresponding

to increasing rates of cancer. This study

aims to assess the feasibility and

acceptability of routine introduction of

geriatric screening and comprehensive

geriatric assessment for older people with

cancer at their initial assessment (new

diagnosis or recurrent disease) in

ambulatory cancer clinics.

Phase IIb double-blind, placebo-controlled study of oral delta-9-tetrahydrocannabinol (Namisol®) for anorexia in people with advanced cancer

M Agar and the Cannabinoids for Cancer Symptoms Research Group

Anorexia is experienced by 90% of patients

with advanced cancer. This study will

determine if Namisol, which contains the

component of cannabis that affects

appetite, can improve anorexia-related

symptoms in the advanced cancer

population compared to placebo.

Cannabis – Botanical Leaf

M Agar (Lead Investigator)

Anorexia is the second most common

condition in advanced cancer, affecting up

to 90% of sufferers. This study investigates

the use of vaporised cannabis botanical

flower bud to increase appetite in this

population. It is hypothesised that the

vaporised botanical flower bud will have

more rapid absorption and effects

compared to other oral forms of cannabis.

Randomised, double-blind, placebo-controlled phase III trial of oral melatonin for the prevention of delirium in hospital in people with advanced cancer

M Agar, D Currow, J Phillips, A Hosie, T Luckett

Two thirds of people with advanced cancer

will have a delirium episode at some point

whilst in hospital. This study will determine

if oral prolonged release melatonin

compared to placebo can increase the

number of delirium-free days during

hospitalisation for advanced cancer

patients.

11

A randomised, controlled study of oral ondansetron versus oral olanzapine versus oral haloperidol in patients with cancer and nausea not related to anti-cancer therapy (Nausea 4 study pilot)

P Good, J Hardy, J Philip, J Weil, P Yates, G Crawford, R McNeil

Nausea not related to chemotherapy

remains an important and under-

researched health problem. Olanzapine and

ondansetron are both used for

chemotherapy-induced nausea and

vomiting and are often used “off label” for

nausea not related to chemotherapy. This

study compares these medications against

the standard treatment for nausea not

related to chemotherapy to provide quality

clinical evidence of their effectiveness to

treat this under-researched health problem.

PRESERVE 2

A Hosie (Lead Investigator)

Delirium is a significant medical

complication for hospitalised patients. The

aim of this study is to determine if a

multicomponent non-pharmacological

delirium prevention intervention is feasible

and acceptable for in-patients with

advanced cancer.

Improving the management of inoperable malignant bowel obstruction (IMBO)

D Currow, M Agar, K Clark, C Sheehan, A Davis, A Engel

Inoperable malignant bowel obstruction is a

cancer symptom with very poor prognosis,

with symptoms of feculent vomiting,

nausea, and abdominal pain. There is no

registered pharmacological therapy to treat

this. This feasibility study will investigate the

use of Dexamethasone and/or Ranitidine as

a potential treatment.

LICPain: Lidocaine for Neuropathic Cancer Pain – Feasibility study

J Lee, M Agar, D Currow, M Lovell, J Phillips, A McLachlan, B Noble, L Brown, N McCaffrey, B Fazekas

Neuropathic cancer pain is often treated

with opioids and adjuvant analgesia;

however these can lead to worsening of

physical, cognitive and social functioning.

Lidocaine offers an innovative approach to

more effective management of this type of

pain without significant psychoactive effects

of current treatment. This study is the first

randomised control trial of continuous

subcutaneous infusion of lidocaine in

cancer pain or in palliative care.

Cancer Pain Assessment Study

J Phillips (Lead Investigator)

Cancer pain is a major problem for up to

75% of cancer patients. This study will

determine if a tailored mHealth intervention

targeting clinicians’ cancer pain

assessment capabilities is effective in

reducing self-reported cancer pain scores.